DESCRIPTION (investigator's abstract): The overall objective of this study is to evaluate the effectiveness of brief counseling sessions for the management of obesity. The interventions are: Treatment A: orlistat + 12 monthly clinic visits (no cognitive behavior therapy [CBT]); Treatment B: 12 monthly brief individual CBT counseling sessions; Treatment C: orlistat + 12 monthly brief individual CBT counseling sessions. The proposed study will recruit and randomly assign 246 obese (BMI 30 to 40) adult women and men to the three conditions for one year. Specific Aim 1 is to compare the effectiveness of the treatment groups as assessed by changes in BMI and weight. Specific Aim 2 is to compare changes in other health outcomes (blood lipids, blood pressure and glucose). Secondary hypotheses will include examination of main effects and attendance, pill counts, dietary recall and exercise recall and maintenance of weight losses. The investigators believe that this study is significant because it will test a model for obesity treatment (brief individual CBT counseling) that can be applied expeditiously and conveniently to patients in a primary care setting.